Related Stories

Last time, I talked about the condition, Tourette syndrome, and how it can present itself in different people in different ways.

At first, we thought that Tourettes was rare and severe. But we now know that it is relatively common and often mild.

It occurs worldwide in all cultures. Back in 1972, the US National Institute of Health estimated that there were fewer than 100 people with Tourettes in the whole of the USA.

But the current estimate is that it affects up to one per cent of the population (about 300,000 Americans). Males are two to ten times more frequently affected than are females.

Strangely, about 40–70 per cent of Tourettes sufferers appear to have attention deficit hyperactivity disorder (ADHD), while 20–60 per cent have obsessive-compulsive disorder (OCD).

In many cases, these conditions cause more distress to the patient than the Tourettes.

The so-called 'pure Tourettes' or 'Tourettes-only' is the syndrome without the OCD, ADHD or other disorders. This accounts for about 40 per cent of those with Tourettes.

In general, Tourettes starts with simple motor tics presenting first (say, 5–10 years of age), and the more complex motor tics appearing later, with vocal tics developing at 8–15 years.

Tourettes is usually worst during adolescence.

On average, in about two-thirds of Tourettes sufferers, the symptoms get better as they get older. Unfortunately, in one third, they do not.

There can be unexpected side effects. For example, if the motor tics include head jerking, the head involvement can cause muscle strain to the neck, and even make reading very difficult.

One strange characteristic of Tourettes is that the symptoms wax and wane, with no obvious pattern. The symptoms are unpredictable, being very different from day to day and week to week.

In general, Tourettes does not affect life expectancy.

The cause?

At this stage, we do know that there is a very strong genetic component to the disease. It might be related to a site on chromosome 8, and possibly chromosomes 5 and/or 11.

There might also be a non-genetic component to Tourettes, possibly as a reaction to being infected by a Streptococcus bacterium. (But on the other hand, most people do get a streptococcus infection at some stage in their early life, and don't get Tourettes.)

It seems that Tourettes is a disorder of the synaptic neurotransmitter chemicals that transmit information.

Scanning studies of the brains of Tourettes sufferers show extra activity in those parts of the brain dealing with sensation, movement and language.

To summarise, we don't really know the cause(s) of Tourettes. This is partly because the brain is fiendishly complex.

Another reason is that we have very few animal models to compare and study, apart from some stallions with inherited repetitive grooming rituals, and some Labrador dogs that will lick their paws until they are raw and abraded.

But we know that the risk factors include having a family history of Tourettes, being male and under the age of 20 years.

Tourettes is known as a 'spectrum disease'. This means that it has a whole range of symptoms — from short-lived and mild, to chronic and severe (but fortunately, this is relatively uncommon).

So some people with milder symptoms can cover it up in their daily life.

Some cannot. Dr Samuel Johnson, the writer, critic and poet, who back in the 1700s wrote the first modern dictionary of the English language, had Tourettes.

His biographer, Boswell, wrote that Dr Johnson had "nervous movements", and would often continually repeat fragments of words, or other sounds.

He would suppress these tics with a great effort of his will, as he was much embarrassed by them.

In modern times, the actor Dan Ackroyd claimed in a radio interview that he had mild Tourettes.

Athletes and musicians have claimed they have tamed the restless energy and spontaneity of Tourettes to their own advantage.

A few studies have shown that people with Tourettes can have a higher IQ, and quicker motor activity, than expected.

The famed neurologist and author, Dr Oliver Sacks, writes that while "one must not romanticise Tourettes…one may have the rather rare situation of a biological condition becoming creative or becoming an integral part of the identity and creativity of an individual".

The florid symptoms that most people think typical of Tourette syndrome are actually the least typical symptoms. This is probably because they get all the attention.

The majority of people diagnosed with Tourettes will never do the rude stuff. The rude words and rude gestures appear in only 10–15 per cent of people with Tourettes, and then only for a very small fraction of the day.

The rest of the time, people with Tourettes are just like the rest of us.

Jacob :

Greg Weimar :

Taryn :

17 Mar 2010 4:50:04pm

wow, this is interesting. My 12yo son has Autistic spectrum disorder and has started having tics in the last year, they are getting more apparent but he is ok with them and says it helps him count in his head ( which he does constantly anyway) I have asked his doctor and school about this and they say he's fine, maybe he just does it at home. I feel better knowing how common it is and that he may grow out of it. thanks

Jean :

Tanya :

08 Feb 2011 11:44:35am

My son has Tourette's Syndrome.He started showing symptoms at 6 years old and now nearly 9 his tics are getting more complex. My biggest worry is that as he starts to get older that children in school will pick on him and he wont be able to cope as he is so sensitive about it!I wish i new of more mothers whose chioldren have this disorder.

Jennie :

10 Feb 2011 2:59:05am

Hi, my son is 11, and has had the symptoms of Touretts since he was 4. My doctor told me to ignore it, that maybe he was just a nervous child! Anwya before Christmas, I decided to bite the bullet! So, he had an MRI a few weeks ago, that came back clear. His EEG is on next week, after that I don't know what the next step will be. Kids at school has noticed his tics in the last month, and this worries him. He gets upset at night time, as he can't settle down to go to sleep. I think he has mild ADHD with it.... time will tell.

Angela :

07 May 2011 6:22:25am

I have two children with tourettes. A 17 year old daughter and a 13 year old son. I have learned a lot and been through a lot over the years and would be glad to share with you. I know when I first found out my daughter had tourettes it was so hard to find anyone to talk to that could REALLY undertand. Do you have facebook?

Barbara :

Josie :

11 Dec 2011 11:18:28pm

My son is older now, going on 23 and still with facial tics. They drive him nuts sometimes - particularly when under pressure. The muscles involved start to hurt after awhile.He is creative (a budding comedian/actor/singer) and I was not aware of this link till I read this article tonight. While he is onstage, his tics do not bother him.I heard or read somewhere that attention to diet may also help but cant find evidence of this. Are you aware of any specific ways in which diet may assist in reducing the incidence of tics please?